Healthcare Provider Details

I. General information

NPI: 1972992238
Provider Name (Legal Business Name): MRS. BARBARA GAUVIN-DORCELY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SE FEDERAL HWY
STUART FL
34994-3823
US

IV. Provider business mailing address

9008 SHORT CHIP CIR
PORT ST LUCIE FL
34986-2800
US

V. Phone/Fax

Practice location:
  • Phone: 772-320-0770
  • Fax:
Mailing address:
  • Phone: 954-552-5564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: